Global left ventricular relaxation and diastolic filling is abnormal in many patients with coronary artery disease who have normal left ventricular systolic function. In patients with normal regional wall motion, abnormal diastolic filling, assessed by radionuclide angiography, is related to diastolic asynchrony. In patients with visually apparent regional wall motion abnormalities, systolic asynchrony results in greater impairment in global diastolic filling, and the severity of asynchrony is directly related to the temporal delay in left ventricular filling. These data indicate that asynchronous left ventricular systolic function is a determinant of global abnormalities in left ventricular diastolic function.